The burden of cancer and tobacco consumption are major causes of morbidity and mortality in Kenya, a country with limited research infrastructure and significant scarcity to address these ever increasing chronic, non- communicable disease (NCD) threats to public health. Building on a near 15-year long research collaboration in Nairobi; a 20-year long academic partnership Academic Model Providing Access to Healthcare in Eldoret; capitalizing on a current NCI D43 training grant devoted to AIDS malignancy that is building critical pathology, tumor virology and clinical trials capacity; other NCI and CDC-funded research projects; an international team of highly interactive and experienced investigators led by Drs. Scot Remick, West Virginia University (WVU) and his senior Kenyan collaborator Walter Mwanda, University of Nairobi (UoN); Dr. Geoffrey Mutuma at Kenya Medical Research Institute (KEMRI); Dr. Brigid Sirengo at Nairobi Hospice; Dr. Patrick Loehrer at Indiana University (IU) and his senior Kenyan collaborator Dr. Naftali Busakhala, Moi University (MU) are partnering to develop sustainable research capacity for cancer and tobacco control in Kenya across the lifespan. Our training program will link for the first time the 5 essential academic medical and research centers in Kenya: UoN College of Health Sciences and affiliated Kenyatta National Hospital (KNH) in Nairobi; KEMRI; and the MU College of Health Sciences and affiliated Moi Teaching and Referral Hospital (MTRH) in Eldoret. The overall goal of our D43 training program is to bridge existing research capacity in Kenya, enabling strategic and inclusive multidisciplinary teams that will provide a solid foundation for development and implementation of evidence-based interventions relevant to cancer and tobacco control that will translate into Kenyan public health policy. The essential objectives are to strengthen the infrastructure for cancer and tobacco control in Kenya such that by the end of the 5-year Fogarty award highly interactive teams of investigators and research personnel will: (1) register cancer and other NCD entities (e.g., cerebrovascular disease) in population-based registries to inform national health officials and research programs; (2) develop effective tobacco cessation and control strategies for community intervention(s) and further frame tobacco policy; (3) support pathology research projects for successful completion of the MMed(Pathology) degree program to develop the next generation of trained pathologists for cancer diagnosis and lead multidisciplinary tumor boards; and (4) build research capacity for end-of-life cancer care and generate effective evidence-based interventions especially for children with cancer. Common training themes include: (1) the bulk of the training will be on-site in Kenya, which allows us to provide direct training for more members of our health teams; (2) address both intellectual - people and technical - laboratory capacities; (3) provide a variety of short, medium and long-term, south-to-south, and electronic/web-based training coursework taking advantage of a newly fit-up electronic conference room in the Department of Pathology at UoN; and (4) provide training for the responsible conduct of research, protections of human subjects, and scientific/grants writing that feeds into a pilot research awards mechanism. PUBLIC HEALTH RELEVANCE: This proposal strengthens capacity in Kenya to address the growing burden of cancer and tobacco by developing vital training and research infrastructure, evidence-based approaches for intervention, and impacting public health policy across the lifespan. The training plan builds on 15-year research collaboration in Nairobi, 20-year academic partnership in Eldoret, and trans-DHHS assets including several NCI-supported grants and CDC-funded Prevention Research Center. Importantly, this proposal links for the first time the 5 essential medical research centers in Kenya: Univ. of Nairobi and Moi Univ. medical schools, and their affiliated national referral hospitals and KEMRI.